Página 1 dos resultados de 9542 itens digitais encontrados em 0.014 segundos

Involvement of the midbrain tectum in the unconditioned fear promoted by morphine withdrawal

AVILA, Milton A. V.; RUGGIERO, Rafael N.; CABRAL, Alicia; BRANDAO, Marcus L.; NOBRE, Manoel J.; CASTILHO, Vanessa M.
Fonte: ELSEVIER SCIENCE BV Publicador: ELSEVIER SCIENCE BV
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.91%
The midbrain rectum structures, dorsal periaqueductal gray (dPAG) and inferior colliculus (IC), are involved in the organization of fear and anxiety states during the exposure to dangerous stimuli. Since opiate withdrawal is associated with increased anxiety in both humans and animals, this study aimed to investigate the possible sensitization of the neural substrates of fear in the midbrain tectum and its influence on the morphine withdrawal-induced anxiety. For the production of drug withdrawal, rats received morphine injections (10 mg/kg; s.c.) twice daily during 10 days. Forty-eight hours after the interruption of the chronic treatment, independent groups were probed in the elevated plus-maze and open-field tests. Additional groups of animals were implanted with a bipolar electrode into the dPAG OF the IC and submitted to the electrical stimulation of these structures for the determination of the freezing and escape thresholds after 48 h of withdrawal. Our results showed that the morphine withdrawal promoted clear-cut levels of anxiety without the somatic signs of opiate withdrawal. Moreover, morphine-withdrawn rats had an increase in the reactivity to the electrical stimulation of the dPAG and the IC. These findings suggest that the increased anxiety induced by morphine withdrawal is associated with the sensitization of the neural substrates of fear in the dPAG and the IC. So...

Anxiety-like symptoms induced by morphine withdrawal may be due to the sensitization of the dorsal periaqueductal grey

CASTILHO, V. M.; BORELLI, K. G.; BRANDAO, M. L.; NOBRE, M. J.
Fonte: PERGAMON-ELSEVIER SCIENCE LTD Publicador: PERGAMON-ELSEVIER SCIENCE LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.84%
Withdrawal from morphine leads to the appearance of extreme anxiety accompanied of several physical disturbances, most of them linked to the activation of brainstem regions such as the locus coeruleus, ventral tegmental area, hypothalamic nuclei and periaqueductal grey (PAG). As anxiety remains one of the main components of morphine withdrawal the present study aimed to evaluating the influence of the dorsal aspects of the PAG on the production of this state, since this structure is well-known to be involved in defensive behaviour elicited by anxiety-evoking stimuli. Different groups of animals were submitted to 10 days of i.p. morphine injections, challenged 2 h after with an i.p. injection of naloxone (0.1 mg/kg), and submitted to the plus-maze, open-field and light-dark transition tests. The effects of morphine withdrawal on anxiety-induced Fos immunolabelling were evaluated in four animals that passed by the light-dark transition test randomly chosen for Fos-protein analysis. Besides the PAG, Fos neural expression was conducted in other brain regions involved in the expression of anxiety-related behaviours. Our results showed that morphine withdrawn rats presented enhanced anxiety accompanied of few somatic symptoms. Increased Fos immunolabelling was noted in brain regions well-known to modulate these states as the prelimbic cortex...

Efeito do jejum alimentar na qualidade da carne de frangos de corte criados em sistema convencional; Effect of feed withdrawal in the quality of broilers meat raised in the conventional system

Castro, Janaina Boccia Jorge
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/08/2006 PT
Relevância na Pesquisa
36.87%
O objetivo do trabalho foi avaliar o efeito de diferentes períodos de jejum alimentar (3, 6, 9, 12, 15 e 18 horas) sobre a perda de peso vivo em frangos de corte criados em sistema convencional e o rendimento de carcaça quente e fria (antes e após o resfriamento), além de avaliar os atributos de qualidade da carne de peito de frango. Neste experimento foram utilizados frangos de corte da linhagem Ross com 46 dias de idade. Os resultados encontrados mostraram que o tempo de jejum prolongado teve efeito significativo (p≤0,05) sobre a perda de peso das aves antes do abate, com perda de 5% para um jejum de 12h. Conforme os períodos de jejum aumentavam, também incrementava a quantidade de peso perdido na carcaça viva. Registrou-se um elevado rendimento de carcaça quente com um período entre 3 e 6 horas de jejum e reduzido, a partir de um período de 9 horas acusou uma diferença significativa (p≤0,05). A carcaça fria apresentou uma diminuição no seu rendimento, à medida que aumentou o tempo do jejum, com diferença significativa (p≤0,05), que foi observada a partir de 6 horas de jejum. Os resultados encontrados neste estudo não mostraram que o tempo prolongado da privação de alimentos tenha efeito significativo (p≤0...

Effects of diethylpropion treatment and withdrawal on aorta reactivity, endothelial factors and rat behavior

Da Silva, LBB; Cordellini, S.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 170-176
ENG
Relevância na Pesquisa
36.84%
Diethylpropion (DEP) is an amphetamine-like compound used as a coadjutant in the treatment of obesity and which presents toxicological importance as a drug of abuse. This drug causes important behavioral and cardiovascular complications; however, the vascular and behavioral alterations during DEP treatment and withdrawal, have not been determined. We evaluated the effects of DEP treatment and withdrawal on the rat aorta reactivity to noradrenaline, focusing on the endothelium, and the rat behavior during DEP treatment and withdrawal. DEP treatment caused a hyporreactivity to noradrenaline in aorta, reversible after 2 days of withdrawal and abolished by both the endothelium removal and the presence of L-NAME, but not by the presence of indomethacin. Furthermore, DEP treatment increased the general activity of rats. Contrarily, DEP withdrawal caused a decrease in the locomotor activity and an increase in grooming behavior, on the 2nd and 7th days after the interruption of the treatment, respectively. DEP treatment also caused an adaptive vascular response to noradrenaline that seems to be dependent on the increase in the endothelial nitric oxide system activity, but independent of prostaglandins synthesis. The data evidenced chronological differences in the adaptive responses of the vascular and central nervous systems induced by DEP treatment. Finally...

Epidemiological study on antimicrobial use and non-compliance with withdrawal times in broiler farms in Vietnam

Nguyen, Thi Viet Hang Jr
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
EN
Relevância na Pesquisa
36.84%
L’utilisation d’antimicrobiens chez les animaux de consommation est une source de préoccupation importante pour la santé publique à travers le monde en raison de ses impacts potentiels sur l’émergence de micro-organismes résistants aux antimicrobiens et sur la présence de résidus antimicrobiens néfastes dans la viande. Cependant, dans les pays en développement, peu de données sont disponibles sur les pratiques d’utilisation des antimicrobiens à la ferme. Par conséquent, une étude épidémiologique transversale a été menée de juin à août 2011 dans des élevages de poulets de chair situés dans le sud du Vietnam, ayant pour objectifs de décrire la prévalence d’utilisation des antimicrobiens ajoutés à l’eau de boisson ou aux aliments à la ferme, et de tester les associations entre les caractéristiques des fermes et la non-conformité avec les périodes de retrait recommandés sur l’étiquette des produits. Un échantillon d’accommodement de 70 fermes a été sélectionné. Les propriétaires des fermes ont été interrogés en personne afin de compléter un questionnaire sur les caractéristiques des fermes et les pratiques d’utilisation d’antimicrobiens. Au cours des 6 mois précédant les entrevues...

?+G438-Adrenergic agonists in opioid withdrawal

Gowing, L.; Farrell, M.; Ali, R.; White, J.
Fonte: Carfax Publishing Publicador: Carfax Publishing
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
36.89%
OBJECTIVES: This paper presents the main findings of a systematic (Cochrane) review of the effectiveness of α2-adrenergic agonists in managing opioid withdrawal. DESIGN: The original systematic review included controlled trials that compared α2-adrenergic agonists with another form of treatment (or placebo) in participants who were primarily opioid-dependent. MAIN FINDINGS: Ten studies compared a treatment regime based on an α2-adrenergic agonist with one based on reducing doses of methadone. Withdrawal intensity is similar to, or marginally greater with α2-adrenergic agonists, but signs and symptoms of withdrawal occur and resolve earlier in treatment. Participants stay in treatment longer with methadone. The likelihood of completing withdrawal is similar, or slightly less, with clonidine or lofexidine. Clonidine is associated with more adverse effects than reducing doses of methadone. Three studies compared the α2-adrenergic agonists, clonidine and lofexidine. Lofexidine does not reduce blood pressure to the same extent as clonidine, but is otherwise similar to clonidine. CONCLUSIONS: Participants stay in treatment longer with methadone regimes, which may provide greater opportunity for psychosocial intervention. Methadone regimes may be preferable for withdrawal in outpatient settings where the risk of relapse to heroin use is high. The use of methadone may also facilitate transfer to maintenance treatment should completion of withdrawal become unlikely. For those who are well prepared for withdrawal and seeking earlier resolution of withdrawal symptoms...

Steady-state pharmacokinetics and pharmacodynamics in methadone maintenance patients: comparison of those who do and do not experience withdrawal and concentration-effect relationships

Dyer, K.; Foster, D.; White, J.; Somogyi, A.; Menelaou, A.; Bochner, F.
Fonte: MOSBY-YEAR BOOK INC Publicador: MOSBY-YEAR BOOK INC
Tipo: Artigo de Revista Científica
Publicado em //1999 EN
Relevância na Pesquisa
36.91%
Objective: To determine plasma racemic methadone concentration-effect relationships for subjective and objective responses and whether pharmacokinetic and/or pharmacodynamic factors influence withdrawal severity. Methods: Eighteen patients enrolled in a public methadone maintenance program, nine of whom experienced significant withdrawal, received constant doses of methadone once daily for at least 2 months. During an interdosing interval, 13 blood samples were collected to measure plasma racemic methadone concentrations (patients); subjective (withdrawal severity, direct opioid effects, and pain threshold) and objective (pupil diameter and respiratory rate) opioid effects were quantified on 11 occasions (all participants). The sigmoid Emax model was used to relate plasma concentrations and effects and to calculate the slope factor (N). The rate of decline in plasma concentration during each hour from the peak to the trough concentration was calculated. Results: There was an inverse relationship between plasma concentrations and withdrawal severity and pupil diameter, as well as a direct relationship with subjective opioid effects and pain threshold. The mean N values were 5.4 plusminus 0.9 for withdrawal severity, 5.1 plusminus 1.1 for subjective opioid effects...

A comparison of antagonist-precipitated withdrawal under anesthesia to standard inpatient withdrawal as a precursor to maintenance naltrexone treatment in heroin users: outcomes at 6 and 12 months

McGregor, C.; Ali, R.; White, J.; Thomas, P.; Gowing, L.
Fonte: Elsevier Sci Ireland Ltd Publicador: Elsevier Sci Ireland Ltd
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
36.91%
To compare two methods of heroin withdrawal, 51 heroin users were randomised to undergo a 1 day precipitated withdrawal procedure using naloxone under anaesthetic. About 50 participants were randomised to receive the current standard inpatient withdrawal treatment using clonidine plus symptomatic medication. Following withdrawal, both groups were offered 9 months of naltrexone treatment and supportive counselling. Outcome measures were: commencement of naltrexone, retention in treatment and heroin use at 6 and 12 months. Significantly more of the precipitated withdrawal group completed withdrawal, commenced naltrexone and stayed in treatment for the first 3 months. Overall, there was a significant reduction in both self-reported heroin use and morphine concentration in hair over the 12 month study period, with participants in the precipitated withdrawal group showing significantly lower morphine concentration at 6 months. Being younger and having a lower level of dependence were predictors of abstinence at 6 and 12 months. The advantage of precipitated withdrawal under anesthesia did not persist beyond 3 months with respect to retention in naltrexone treatment or beyond 6 months with respect to heroin use. Long-term follow-up is crucial in assessing the effects of treatment interventions for heroin dependence.; Catherine McGregor...

Antagonist-precipitated heroin withdrawal under anaesthetic prior to maintenance naltrexone treatment: determinants of withdrawal severity

Ali, R.; Thomas, P.; White, J.; McGregor, C.; Danz, C.; Gowing, L.; Stegink, A.; Athanasos, P.A.
Fonte: Carfax Publishing Publicador: Carfax Publishing
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
36.94%
This study sought to characterize antagonist-precipitated heroin withdrawal during and immediately following anaesthesia and to identify the determinants of withdrawal severity and duration in 48 dependent heroin users. Objective withdrawal signs decreased significantly with each naloxone bolus administered under anaesthetic. The cost (amount) of the final heroin administration and the number of hours between last heroin use and commencement of anaesthesia were significant, independent predictors of the severity of withdrawal symptomatology. While 83% (40/48) of participants completed withdrawal according to objective criteria and commenced maintenance naltrexone treatment, almost half (22/48) were unable to commence naltrexone on the day of the procedure due to residual withdrawal signs. Fourteen of these 22 participants subsequently commenced naltrexone (median number of days between admission and commencement of naltrexone was 2, range 1 – 6) while eight left treatment prior to initiation of naltrexone. Significantly fewer of those with more severe withdrawal signs during anaesthesia commenced naltrexone (40% vs. 60%). While the severity and duration of withdrawal symptomatology may be moderated by encouraging participants to reduce (or cease) heroin use close to the time of withdrawal...

In-patient benzodiazepine withdrawal: comparison of fixed and symptom-triggered taper methods

McGregor, C.; Machin, A.; White, J.
Fonte: Carfax Publishing Publicador: Carfax Publishing
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
36.89%
Fixed and symptom-triggered taper methods during in-patient benzodiazepine withdrawal treatment were compared using a randomized controlled design. Forty-four benzodiazepine users seeking in-patient withdrawal treatment at two substance use treatment clinics in Adelaide, Australia were recruited. Measurements included the Severity of Dependence Scale and the SF-36. A scale comprising six items from the Clinical Institute Withdrawal Assessment Scale—Benzodiazepines (CIWA-B) was used to measure withdrawal symptoms. Participants were randomized to receive a fixed diazepam tapering regime or diazepam only in response to withdrawal symptoms (symptom-triggered group). Results showed that there were no significant differences between treatment groups in terms of withdrawal severity, duration of in-patient treatment, amount of diazepam administered, treatment attrition and benzodiazepine use at follow-up. Both groups showed a reduction in benzodiazepine dosage of 86% over the first 8 days which was maintained at 1 month post-discharge. Although there were improvements in some subscales of the SF-36 between baseline and follow-up, values were significantly below age-matched norms at both time-points. This study showed that benzodiazepine users entering treatment have relatively poor health and that symptom-triggered taper methods incorporating flexible dosing and flexible treatment duration are as effective as fixed dose taper methods for in-patient benzodiazepine withdrawal treatment. [McGregor C...

The nature, time course and severity of methamphetamine withdrawal

McGregor, C.; Srisurapanont, M.; Jittiwutikarn, J.; Laobhripatr, S.; Wongtan, T.; White, J.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
Relevância na Pesquisa
36.87%
AIMS: To characterize the natural history of methamphetamine withdrawal during the first 3 weeks of abstinence. DESIGN: Cross-sectional study with comparison group. SETTING: A substance use treatment facility in Chiang Mai Province, Thailand. PARTICIPANTS: The sample comprised 21 in-patients undergoing treatment for methamphetamine dependence. Nine age- and sex-matched non-dependent individuals provided comparison data. MEASUREMENTS: Instruments including: the Amphetamine Withdrawal Questionnaire, a modified version of the Cocaine Selective Severity Assessment, Clinical Global Impression scale and the St Mary’s Hospital Sleep Questionnaire were completed daily for the first 3 weeks of abstinence. FINDINGS: Methamphetamine withdrawal severity declined from a high initial peak within 24 hours of the last use of amphetamines reducing to near control levels by the end of the first week of abstinence (the acute phase). The acute phase of amphetamine withdrawal was characterized by increased sleeping and eating, a cluster of depression-related symptoms and less severely, anxiety and craving-related symptoms. Following the acute withdrawal phase most withdrawal symptoms remained stable and at low levels for the remaining 2 weeks of abstinence. CONCLUSIONS: This study has provided evidence of a methamphetamine withdrawal syndrome that can be categorized into two phases...

Amphetamine withdrawal : nature, time course and treatment.

McGregor, Catherine
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado Formato: 845837 bytes; 677221 bytes; 998585 bytes; 236961 bytes; application/pdf; application/pdf; application/pdf; application/pdf
Publicado em //2005 EN
Relevância na Pesquisa
36.89%
Increased demands on amphetamine dependence treatment services point to a need for effective pharmacotherapies for withdrawal symptom suppression. However, empirical data on which to base effective treatments are scarce. To address the need for an evidence base, four studies were conducted in two countries - Australia and Thailand. Firstly, the time course and severity of amphetamine withdrawal symptoms were characterised in two inpatient samples of amphetamine users. Results identified the first week of abstinence as an acute withdrawal phase characterised by increased sleeping, eating and a cluster of mood and anxiety - related symptoms. Following the acute phase, most withdrawal symptoms remained stable and at low levels for the remaining two weeks of abstinence ( the sub - acute phase ). Data from these two studies formed the basis for a new instrument, the Amphetamine Cessation Symptom Assessment scale ( ACSA ). On psychometric testing, the ACSA showed satisfactory reliability and a clear psychometric structure, delineating symptom clusters and their correlates with a three factor solution providing the best fit to the data. Using the ACSA to measure outcome, the safety and efficacy of the serotonin and noradrenaline reuptake inhibitor antidepressant mirtazapine ( 15 - 60 mg per day...

Alpha2-adrenergic agonists for the management of opioid withdrawal (review)

Gowing, L.; Farrell, M.F.; Ali, R.; White, J.M.
Fonte: John Wiley and Sons Publicador: John Wiley and Sons
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
36.96%
BACKGROUND: Withdrawal is a necessary step prior to drug-free treatment or as the endpoint of long-term substitution treatment. OBJECTIVES: To assess the effectiveness of interventions involving the use of alpha2-adrenergic agonists compared with placebo, reducing doses of methadone, symptomatic medications or with comparison of different alpha2-adrenergic agonists, for the management of the acute phase of opioid withdrawal. Outcomes included the intensity of signs and symptoms and overall withdrawal syndrome experienced, duration of treatment, occurrence of adverse effects and completion of treatment. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (Issue 7, 2013), MEDLINE (1946 to July week 4, 2013), EMBASE (January 1985 to August week 1, 2013), PsycINFO (1806 to July week 5, 2013) and reference lists of articles. We also contacted manufacturers in the field. SELECTION CRITERIA: Randomised controlled trials comparing alpha2-adrenergic agonists (clonidine, lofexidine, guanfacine, tizanidine) with reducing doses of methadone, symptomatic medications or placebo, or comparing different alpha2-adrenergic agonists to modify the signs and symptoms of withdrawal in participants who were opioid dependent. DATA COLLECTION AND ANALYSIS: One review author assessed studies for inclusion and undertook data extraction. All review authors decided on inclusion and confirmed the overall process. MAIN RESULTS: We included 25 randomised controlled trials...

Alpha₂-adrenergic agonists for the management of opioid withdrawal; Alpha(2)-adrenergic agonists for the management of opioid withdrawal

Gowing, L.; Farrell, M.; Ali, R.; White, J.
Fonte: John Wiley & Sons Publicador: John Wiley & Sons
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.91%
BACKGROUND: Withdrawal is a necessary step prior to drug-free treatment or as the end point of long-term substitution treatment. OBJECTIVES: To assess the effectiveness of interventions involving the use of alpha2-adrenergic agonists to manage opioid withdrawal. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2008), MEDLINE (January 1966-July 2008), EMBASE (January 1985-2008 Week 31), PsycINFO (1967 to 7 August 2008) and reference lists of articles. We also contacted manufacturers in the field. SELECTION CRITERIA: Controlled trials comparing alpha2-adrenergic agonists with reducing doses of methadone, symptomatic medications or placebo, or comparing different alpha2-adrenergic agonists to modify the signs and symptoms of withdrawal in participants who were opioid dependent. DATA COLLECTION AND ANALYSIS: One author assessed studies for inclusion and undertook data extraction. Inclusion decisions and the overall process were confirmed by consultation between all authors. MAIN RESULTS: Twenty-four studies, involving 1631 participants, were included. Twenty-one were randomised controlled trials.Thirteen studies compared a treatment regime based on an alpha2-adrenergic agonist with one based on reducing doses of methadone. Diversity in study design...

Opioid antagonists with minimal sedation for opioid withdrawal

Gowing, L.; Ali, R.; White, J.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.94%
Background Managed withdrawal is a necessary step prior to drug-free treatment or as the end point of long-term substitution treatment. Objectives To assess the effectiveness of opioid antagonists in combination with minimal sedation to manage opioid withdrawal. Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), MEDLINE (January 1966-July 2008), EMBASE (January 1985-2008 Week 31), PsycINFO (1967 to 7 August 2008) and reference lists of articles. Selection criteria Controlled studies of interventions involving the use of opioid antagonists in combination with minimal sedation to manage withdrawal in opioid-dependent participants compared with other approaches or different opioid antagonist regimes. Data collection and analysis One author assessed studies for inclusion and undertook data extraction. Inclusion decisions and the overall process were confirmed by consultation between all authors. Main results Nine studies (6 randomised controlled trials), involving 837 participants, met the inclusion criteria for the review. The quality of the evidence is low, but suggests that withdrawal induced by opioid antagonists in combination with an adrenergic agonist is more intense than withdrawal managed with clonidine or lofexidine alone...

Buprenorphine for the management of opioid withdrawal

Gowing, L.; Ali, R.; White, J.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
36.98%
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the end point of substitution treatment. OBJECTIVES: To assess the effectiveness of interventions involving the use of buprenorphine to manage opioid withdrawal, for withdrawal signs and symptoms, completion of withdrawal and adverse effects. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), MEDLINE (January 1966 to July 2008), EMBASE (January 1985 to 2008 Week 31), PsycINFO (1967 to 7 August 2008) and reference lists of articles. SELECTION CRITERIA: Randomised controlled trials of interventions involving the use of buprenorphine to modify the signs and symptoms of withdrawal in participants who were primarily opioid dependent. Comparison interventions involved reducing doses of methadone, alpha(2)-adrenergic agonists, symptomatic medications or placebo, or different buprenorphine-based regimes. DATA COLLECTION AND ANALYSIS: One author assessed studies for inclusion and methodological quality, and undertook data extraction. Inclusion decisions and the overall process was confirmed by consultation between all authors. MAIN RESULTS: Twenty-two studies involving 1736 participants were included. The major comparisons were with methadone (5 studies) and clonidine or lofexidine (12 studies). Five studies compared different rates of buprenorphine dose reduction.Severity of withdrawal is similar for withdrawal managed with buprenorphine and withdrawal managed with methadone...

Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal (review)

Gowing, L.; Ali, R.; White, J.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
36.97%
Background: Withdrawal (detoxification) is necessary prior to drug-free treatment. It may also represent the end point of long-term opioid replacement treatment such as methadone maintenance. The availability of managed withdrawal is essential to an effective treatment system. Objectives: To assess the effectiveness of interventions involving the administration of opioid antagonists to induce opioid withdrawal with concomitant heavy sedation or anaesthesia, in terms of withdrawal signs and symptoms, completion of treatment and adverse effects. Search strategy: We searched the Drugs and Alcohol Group register (October 2003), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2004), Medline (January 1966 to January 2005), Embase (January 1985 to January 2005), PsycINFO (1967 to January 2005), and Cinahl (1982 to December 2004) and reference lists of studies. Selection criteria: Controlled trials comparing antagonist-induced withdrawal under heavy sedation or anaesthesia with another form of treatment, or a different regime of anaesthesia-based antagonist-induced withdrawal. Data collection and analysis: One reviewer assessed studies for inclusion and undertook data extraction and assessed quality. Inclusion decisions and the overall process were confirmed by consultation between all three reviewers. Main results: Six studies (five randomised controlled trials) involving 834 participants met the inclusion criteria for the review. Antagonist-induced withdrawal is more intense but less prolonged than withdrawal managed with reducing doses of methadone...

Sensitization to morphine withdrawal in guinea-pigs

Mizutani, Akiko; Arvidsson, Jenny; Chahl, Loris A
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
36.89%
The aim of this study was to determine whether sensitization occurred to morphine withdrawal. Guinea-pigs were treated twice daily with increasing doses of morphine (10-100 mg/kg s.c.) for 3 days followed by injection of morphine 100 mg/kg on the fourth day. Sixty min after the last morphine injection, animals were withdrawn from morphine with naltrexone, 15 mg/kg s.c., and locomotor activity and all other behaviours scored over 90 min. Animals were then rested for 3 days. This procedure was repeated twice over the next 2 weeks. Control animals were treated with saline for the first two treatment cycles. Guinea-pigs subjected to three cycles of morphine withdrawal showed a significant increase in the total number of withdrawal behaviour counts over the 90-min observation period following the third cycle of withdrawal compared with the first and second withdrawal cycles. However, locomotor activity, a major sign of morphine withdrawal in guinea-pigs, was not significantly increased. Fos-LI was markedly increased in the repeatedly withdrawn animals in several brain regions, including amygdala, dorsal striatum, thalamus, ventral tegmental area, and ventrolateral periaqueductal gray area. It is concluded that sensitization to morphine withdrawal occurs in guinea-pigs.

A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal

Lintzeris, Nicholas; Bammer, Gabriele; Jolley, Damien; Rushworth, Louise; Bell, James
Fonte: Carfax Publishing, Taylor & Francis Group Publicador: Carfax Publishing, Taylor & Francis Group
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
36.97%
Aim: To determine whether buprenorphine is more effective than clonidine and other symptomatic medications in managing ambulatory heroin withdrawal. Design: Open label, prospective randomized controlled trial examining withdrawal and 4-week postwithdrawal outcomes on intention-to-treat. Setting: Two specialist, out-patient drug treatment centres in inner city Melbourne and Sydney, Australia. Participants: One hundred and fourteen dependent heroin users were recruited. Participants were 18 years or over, and with no significant other drug dependence, medical or psychiatric conditions or recent methadone treatment. One hundred and one (89%) participants completed a day 8 research interview examining withdrawal outcomes, and 92 (81%) completed day 35 research interview examining postwithdrawal outcomes. Interventions: Participants randomized to control (n = 56) (up to 8 days of clonidine and other symptomatic medications) or experimental (n = 58) (up to 5 days of buprenorphine) withdrawal groups. Following the 8-day withdrawal episode, participants could self-select from range of postwithdrawal options (naltrexone, substitution maintenance, or counselling). Measurements: Retention in withdrawal; heroin use during withdrawal; and retention in drug treatment 4 weeks after withdrawal. Secondary outcomes: Withdrawal severity; adverse events...

Accelerated withdrawal from methadone maintenance therapy using naltrexone and minimal sedation: a case series analysis

Glasgow, Nicholas; Taylor, Jo; Bell, James; Young, M; Bammer, Gabriele
Fonte: Carfax Publishing, Taylor & Francis Group Publicador: Carfax Publishing, Taylor & Francis Group
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
36.87%
The aim of this study was to measure the acceptability to stable methadone maintenance clients seeking termination of methadone treatment of accelerated withdrawal using a standardized protocol of naltrexone and minimal sedation; and to provide a first assessment of the probable demand for such treatment, characterize the withdrawal experience, and describe the outcomes for the clients using naltrexone for maintenance therapy for 3 months following withdrawal. We used an open label observational study of 14 stable, methadone maintenance programme clients within the Australian Capital Territory. We found a high degree of acceptability of the withdrawal approach to clients and staff. Three phases of withdrawal identified over a 3-week period. There was rapid attrition from naltrexone maintenance over 3 months of follow-up and a return to dependent opiate use in four clients. The protocol is a humane, effective approach to accelerated withdrawal from methadone maintenance. It is a useful modification to ultra-rapid and other rapid withdrawal techniques. Naltrexone maintenance has a limited potential role in this group of subjects. This role also needs further clarification through well-designed randomized clinical trials.